After ovarian epithelial cancer has been diagnosed,
tests are done to find out if cancer cells have spread within the ovaries or to
other parts of the body.

The process used to find out if
cancer has spread within the
ovary or to other parts of the body
is called staging. The information gathered from the
staging process determines the stage of the disease. It is important
to know the stage in
order to plan treatment. The following procedures may be done:

Laparotomy: The doctor cuts into the
abdomen and carefully looks at all
the organs to see if they contain cancer. The doctor will also do a biopsy
(cut out small pieces of tissue so they can be looked at under a microscope to
see whether they contain cancer). Usually the doctor will remove the cancer and
organs that contain cancer during the laparotomy. (See the Treatment
Options by Stage section.)

Through the blood. Cancer invades the veins and capillaries and travels through the blood to other places in the body.

When cancer cells break away from the primary (original) tumor and travel through the lymph or blood to other places in the body, another (secondary) tumor may form. This process is called metastasis. The secondary (metastatic) tumor is the same type of cancer as the primary tumor. For example, if breast cancer spreads to the bones, the cancer cells in the bones are actually breast cancer cells. The disease is metastatic breast cancer, not bone cancer.

The following stages are used for ovarian epithelial
cancer:

Stage I

Ovarian cancer stage IA, IB, and IC. In stage IA, cancer is found inside a single ovary. In stage IB, cancer is found inside both ovaries. In stage IC, cancer is found in one or both ovaries and one of the following is true: (a) cancer is found on the outside surface of one or both ovaries, (b) the capsule (outer covering) of the ovary has broken open, or (c) cancer cells are found floating in the peritoneal fluid surrounding abdominal organs or in washings of the peritoneum.

In stage I, cancer is
found in one or both ovaries. Stage I is divided into stage IA, stage IB, and stage IC.

Ovarian cancer stage IIA, IIB, and IIC. In stage IIA, cancer is found inside one or both ovaries and has spread to the uterus and/or the fallopian tubes. In stage IIB, cancer is found inside one or both ovaries and has spread to other tissues within the pelvis. In stage IIC, cancer is found inside one or both ovaries and has spread to the uterus and/or fallopian tubes and/or other tissue within the pelvis, and one of the following is true: (a) cancer is found on the outside surface of one or both ovaries, (b) the capsule (outer covering) of the ovary has broken open, or (c) cancer cells are found floating in the peritoneal fluid surrounding abdominal organs or in washings of the peritoneum.

In stage II, cancer is
found in one or both ovaries and has spread into other areas of the
pelvis. Stage II is divided
into stage IIA, stage IIB, and stage IIC.

Stage IIIA ovarian cancer. In stage IIIA, cancer is found in one or both ovaries and has spread to other tissue within the pelvis. Cancer cells that can only be seen with a microscope have spread to the surface of the peritoneum. Cancer that has spread to the surface of the liver is also considered to be stage III.

Stage IIIB ovarian cancer. In stage IIIB, cancer is found in one or both ovaries and has spread to other tissue within the abdomen and to the peritoneum, where it is 2 centimeters or smaller in diameter. Cancer that has spread to the surface of the liver is also considered to be stage III.

Stage IIIC ovarian cancer. In stage IIIC, cancer is found in one or both ovaries and has spread to (a) the peritoneum, where it is larger than 2 centimeters in diameter, and/or (b) lymph nodes in the abdomen. Cancer that has spread to the surface of the liver is also considered to be stage III.

Cancer that has spread to the surface of the liver is also considered stage III ovarian cancer.

Stage IV

Stage IV ovarian cancer. Cancer is found in one or both ovaries and may spread to other parts of the body, such as the lymph nodes, lung, liver, and bone. Cancer cells may also be found in an area between the lungs and the chest wall that has filled with fluid.